Lateral Epicondylitis
史瑞田 主任
國軍桃園總醫院 骨科部
A 32-year-old male worker complained of right elbow pain for 8 months. He experienced conservative treatment including: medication (NSAID), rehabilitation program, needle acupuncture, and local steroid injection but fail after these therapies. He had received the ultrasound study (Fig. 1) in my hospital. It demonstrated partial tear of ECRB and inflammation around lateral epicondyle region.
On account of the symptoms, the elbow arthroscopic release the origin of ECRB and ED were arranged. He was admitted for the operation. Under GA, patient on prone position, right upper extremity was applied with sterized toniquene (Fig. 2).
Procedure :
1. Standard anterolateral and antromedial portals were installed. (Fig. 3) The scope was inserted from antromedial portal and working portal is anterolateral portal.
2. Arthroscopic release of the ECRB and ED origin. All inflammation synovium or plica was resected with shaver or RF probe. The inserted origin of RCRB and ED was release with RF probe. (Fig. 4)
3. The lateral epicondyle was then decorticated with a burr. (Fig. 5)
4. Filled up with 10cc local anesthesia for pain relief.
Postoperation rehabilitation: I applied the long arm splinting for 10 days, then began the isometric exercise. Four weeks later, active exercised versus resistance began applied. He back his work about 6 weeks post operation. (Fig 6)
